INDS 211 Lecture Notes - Lecture 25: Complications Of Pregnancy, Fibrin Degradation Product, Amniotic Fluid Embolism

• School: McGill University
• Department: Interndisciplinary Studies
• Course: INDS 211
• Professor: Bill Buckett

Document Summary

Obstetric complications: massive obstetric haemorrhage, major contributor to maternal mortality, def: blood loss requiring replacement of patient"s total blood volume, transfusion requiring >10 u of blood in 24/24, 50% replacement of blood vol. <3/24 period: difficult to estimate blood loss, should stay ahead of the loss by consulting hemotology and transfusing at least 6u (o-neg in emergent until x- mathcing can be done; 1unit = 500ml) Cord prolapse: malpresentation, problem of concealed bleeding: 1) uterus (couverlaire uterus of abruption), 2) broad ligament haematoma, 3) Recognising significant blood loss: 10 20%: 500-1000ml; normal bp; no signs. Bacterial endo and exotoxins: endothelial injury can also be caused by. Microorganisms=rickettsae, meningococci: plasmin fibrinolysis formation of fibrin degradation products (fdp) Adrenals = bilateral adrenal hemorrhage: resembles waterhouse - friderichsen syndrome. Brain= microinfarcts surrounded by foci of hemorrhage. Heart and anterior pituitary= show similar changes: clinically= bleeding tendency in presence of widespread coagulation. Acute d. i. c. = dominated by a bleeding seen in obstetrical complications and trauma.